Kim Sunyoung, Won Chang Won
Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Arch Gerontol Geriatr. 2022 Sep-Oct;102:104711. doi: 10.1016/j.archger.2022.104711. Epub 2022 May 5.
Aging causes changes in body composition, in which differences in the distribution and amount of fat and muscle tissue affect the development of various diseases according to sex. We conducted a systemic review of the literature and examined the relationship between body composition differences and related health conditions or diseases in older men and women.
Three different electronic databases (MEDLINE, Web of Science, and Embase) were used to find articles from 2000 until March 2022. Information on the study design characteristics, setting, measure of body composition, and health outcomes was extracted.
A total of 217 articles were retrieved, and 28 studies met the inclusion criteria. The included studies showed that older men have larger skeletal muscle mass (sMM) than women, while older women have larger fat mass (FM) than men. sMM has a favorable effect on physical performance, bone density, metabolism, cognitive function, and mortality in both men and women; however, the effects of sMM in women are less significant and even negligible compared to those in men. FM is significantly unfavorable for physical performance in women but sometimes favorable or unfavorable for glucose level and cognitive and lung function according to location. FM in men is usually less important for function, bone density, glucose level, and cognitive function than in women.
Changes in muscle and fat distribution according to aging and their correlation with health outcomes differ according to sex. Muscle mass may not always be favorable, and fat mass may not always be unfavorable in older adults.
衰老会导致身体成分发生变化，其中脂肪和肌肉组织的分布及数量差异会根据性别影响各种疾病的发展。我们对文献进行了系统综述，并研究了老年男性和女性身体成分差异与相关健康状况或疾病之间的关系。
使用三个不同的电子数据库（MEDLINE、科学网和Embase）查找2000年至2022年3月期间的文章。提取了有关研究设计特征、研究背景、身体成分测量方法和健康结果的信息。
共检索到217篇文章，28项研究符合纳入标准。纳入的研究表明，老年男性的骨骼肌质量（sMM）大于女性，而老年女性的脂肪质量（FM）大于男性。sMM对男性和女性的身体机能、骨密度、新陈代谢、认知功能和死亡率均有积极影响；然而，与男性相比，sMM对女性的影响较小，甚至可以忽略不计。FM对女性的身体机能有显著不利影响，但根据其位置，有时对血糖水平、认知功能和肺功能有有利或不利影响。男性的FM对功能、骨密度、血糖水平和认知功能的影响通常比女性小。
随着年龄增长，肌肉和脂肪分布的变化及其与健康结果的相关性因性别而异。在老年人中，肌肉质量不一定总是有益的，脂肪质量也不一定总是有害的。
